Pre-hospital risk factors for inpatient death from severe febrile illness in Malian children

Autor: Eugene Dembélé, Chiaka Diakité, Jacques Falquet, Sergio Giani, Bertrand Graz, Bethany Shinkins, Moussa I. Dicko, Merlin Willcox, Mathieu Forster, Drissa Diallo
Rok vydání: 2011
Předmět:
Male
Pediatrics
Social Sciences
Mali
Global Health
Database and Informatics Methods
Sociology
Risk Factors
Case fatality rate
Infant Mortality
Medical Sociology
Medicine and Health Sciences
Public and Occupational Health
Prospective cohort study
Child
Multidisciplinary
Mortality rate
Child Health
Socioeconomic Aspects of Health
Infectious Diseases
Child
Preschool
Child Mortality
Medicine
Female
Research Article
medicine.medical_specialty
Science
Health Informatics
Research and Analysis Methods
Sexual and Gender Issues
Sex Factors
Health Economics
medicine
Parasitic Diseases
Humans
Risk factor
Health Care Quality
Survival analysis
Primary Care
Inpatients
Health Care Policy
business.industry
Health Services Administration and Management
Infant
medicine.disease
Infant mortality
Malaria
Child mortality
Health Care
business
Delivery of Health Care
Medical Humanities
Zdroj: PLoS ONE
PLoS ONE, Vol 9, Iss 7, p e102530 (2014)
Plos One, vol. 9, no. 7, pp. e102530
ISSN: 1932-6203
Popis: BackgroundInpatient case fatality from severe malaria remains high in much of sub-Saharan Africa. The majority of these deaths occur within 24 hours of admission, suggesting that pre-hospital management may have an impact on the risk of case fatality.MethodsProspective cohort study, including questionnaire about pre-hospital treatment, of all 437 patients admitted with severe febrile illness (presumed to be severe malaria) to the paediatric ward in Sikasso Regional Hospital, Mali, in a two-month period.FindingsThe case fatality rate was 17.4%. Coma, hypoglycaemia and respiratory distress at admission were associated with significantly higher mortality. In multiple logistic regression models and in a survival analysis to examine pre-admission risk factors for case fatality, the only consistent and significant risk factor was sex. Girls were twice as likely to die as boys (AOR 2.00, 95% CI 1.08-3.70). There was a wide variety of pre-hospital treatments used, both modern and traditional. None had a consistent impact on the risk of death across different analyses. Reported use of traditional treatments was not associated with post-admission outcome.InterpretationAside from well-recognised markers of severity, the main risk factor for death in this study was female sex, but this study cannot determine the reason why. Differences in pre-hospital treatments were not associated with case fatality.
Databáze: OpenAIRE
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